Physician-led Medical Groups

Part
01
of three
Part
01

Physician-led Medical Groups Affiliated With a Hospital System

Greensboro Radiology, North Carolina Heart and Vascular (Raleigh), WakeMed Physicians and Practices, UNC Physicians Network (UNCPN), UNC Senior Alliance, UNC Health Alliance, Wake Internal Medicine Consultants, Inc., Raleigh Medical group, Raleigh Adult Medicine, and Wake Endoscopy Center are 10 more of the top physician-led medical groups that have an affiliation/partnership with a major hospital system that are in Greensboro, High Point, Winston Salem, Raleigh, Durham, and/or Charlotte.

GREENSBORO RADIOLOGY

NORTH CAROLINA HEART AND VASCULAR (RALEIGH)

WAKEMED PHYSICIAN PRACTICES

UNC PHYSICIANS NETWORK (UNCPN)

UNC SENIOR ALLIANCE

  • UNC Senior Alliance is UNC Health Care’s physician-led medicare accountable care organization (ACO). The alliance includes UNC Health Care-employed and independent providers. It is accessible via this link.
  • In 2016, UNC Senior Alliance ACO partnered with Chapel Hill, N.C.-based UNC Health Care and Cigna to create a collaborative care program for improving access to care, care coordination and affordability.
  • While this ACO does not list how many physicians it has, it has partnered with several hospitals, including Pruitt Health-Raleigh, Litchford Falls Healthcare, Carolina Point, UNC REX Rehabilitation & Nursing Care Center, and many more.
  • Importantly, UNC Senior Alliance claims to be a Next Generation Accountable Care Organization (ACO), which features a group of doctors, hospitals and other health care providers collaborating with Medicare to offer patients improved, coordinated service, and better care.

UNC HEALTH ALLIANCE

  • UNC Health Alliance is UNC Health Care’s statewide, physician-led clinically integrated network. According to UNC health Care, it is the primary vehicle developed to transform health care delivery and alternative payment models. It is accessible via this link.
  • It serves over 5,000 providers, including UNC Health Care’s affiliate entities and community-based providers.
  • The alliance collaborates with employers, payers, and physicians to collaborate in may areas like care settings, managing costs and quality, and to create more opportunities for statewide care access.
  • UNC Health Alliance is considered a top physician-led medical group because it has approximately 866 health care professionals, 860 primary care providers, and 3,325 specialty providers.

WAKE INTERNAL MEDICINE CONSULTANTS INC.

RALEIGH MEDICAL GROUP (RMG)

  • RMG is recognized by the National Committee for Quality Assurance (NCQA) for providing high-quality services in diabetes care and treatment for heart / stroke patients. Its website is accessible via this link.
  • RMG's expansive network includes Raleigh Adult Medicine, Cary Medical group, and Wake Endoscopy Center.
  • RMG is considered a top physician-led medical group because it is affiliated with major health care providers in N.C. and based on its size i.e., physician count. On that note, its website features a list of 13 physicians with different specialization, including sports medicine, diet and nutrition, and so on.

RALEIGH ADULT MEDICINE

  • Raleigh Adult Medicine uses a patient-centered approach to provide exceptional care to communities and improve the well-being of the members of these communities. Its website is accessible via this link.
  • The medical group is considered a top physician-led medical group in Raleigh because it has over 40 years of experience providing services to residents of Raleigh, it has been recognized by the National Committee for Quality Assurance (NCQA) for providing high-quality care in diabetes and treatment for heart/stroke patients.
  • The medical group lists nine physicians on its website who cover various fields, including sports medicine, diet, and nutrition.

WAKE ENDOSCOPY CENTER

  • Wake Endoscopy Center is fully staffed with physicians, physician assistants, and support staff to provide comprehensive diagnostic and therapeutic services in digestive diseases. Its website is accessible via this link.
  • It lists nine physicians on its website who cover matters regarding gastroenterology and diagnosing digestive diseases.
  • Wake Endoscopy is a top physician-led medical group in Raleigh because it is recognized as a Tier 1 provider by BCBS and Cigna.
  • The group is also a NC State certified ambulatory surgery center. It is 1 of 15 endoscopy facilities in NC that are approved by the AAAHC (Accreditation Association for Ambulatory Health Care).

RESEARCH METHODOLOGY

Extensive searches through North Carolina medical and health care providers databases helped retrieve the ten examples of top physician-led medical groups that have an affiliation/partnership with a major hospital system that are in Greensboro, High Point, Winston Salem, Raleigh, Durham, and/or Charlotte. Importantly, not all medical groups that are physician-led use the term, hence, for some we had to check their management to ascertain that they are physician-led. It is also vital to note that a combination of some metrics were used to ascertain a medical group as top. Several measures such as the number of physicians, recognitions by major medical bodies in the state and nationwide, and awards won for exceptional services. These parameters were adopted since different hospitals focus on different specializations, and using size as the only benchmark to define top could result in the omission of top physician-led groups that focus on advanced surgical specialties that are not flooded by physicians, compared to primary care provider medical groups.

To ensure we have provided a comprehensive list of top physician-led medical groups, we focused on those that specialize in diverse fields to ensure that the list features both sophisticated specialties and common specialties. We also found out that medical groups affiliated with nationwide healthcare providers tend to feature a more robust network of care givers, including hundreds of specialized physicians. Overall, our search focused on only medical groups within the specified locations that are physician-led, which we confirmed by checking the respective websites in case they did not mention that they are physician-led.
Part
02
of three
Part
02

Partnership Details - Aetna and Duke Health

Duke Health, which comprises research, education, and clinical care components partnered with Aetna Health Insurance to foster collaboration between its doctors and the insurance provider. Duke University Health System, Duke University Schools of Medicine and Nursing, and Duke Global Health Institute are the three components forming Duke Health. Detailed below are expanded details of the partnership deal.

AETNA AND DUKE HEALTH PARTNERSHIP

OVERVIEW OF THE PARTNERSHIP

PURPOSE OF THE PARTNERSHIP

BENEFITS TO PATIENTS AND PHYSICIANS

TYPES OF SERVICES OFFERED

RESEARCH METHODOLOGY

Information regarding Aetna and Duke Health partnership under the Aetna Whole Health-Duke Health & WakeMed product is readily available online. However, the information dates back to 2016; hence, the need to adjust search parameters to focus on news, press releases, and medical reports published around this period. Importantly, the findings documented above feature reports, news articles, and press releases published by health systems & hospitals, healthcare providers, insurance companies, and healthcare news outlets. On that note, CVS Health, Aetna, Beckers Hospital Review, Healthcare Finance News, and the North Carolina Medical Society provided information about Aetna Health Insurance and Duke Health.
Part
03
of three
Part
03

Partnership Details - Aetna and WakeMed Health & Hospitals

Aetna and WakeMed Health & Hospitals formed a partnership in August 2016 to provide cost-effective care to select counties in central North Carolina (NC). The following sections describe the details of the partnership.

AETNA AND WAKEMED HEALTH & HOSPITALS PARTNERSHIP

OVERVIEW OF THE PARTNERSHIP

PURPOSE OF THE PARTNERSHIP

BENEFITS TO PATIENTS AND PHYSICIANS

  • Brian Klausner, MD, WakeMed primary care physician and WKCC medical director, told the Triangle Business Journal that working together with Aetna in this new health plan exemplifies a positive step toward reshaping and refining the care delivery system for patients, providers, and customers.
  • The combined services of Aetna, Duke Health, and WakeMed Health & Hospitals creates an extensive network that provides patients access to all levels of health care service, i.e., from prevention and primary care to sophisticated medical and surgical specialties.

TYPES OF SERVICES OFFERED

RESEARCH METHODOLOGY

Since the partnership between Aetna and WakeMed Health & Hospitals occurred in 2016, we had to adjust the time frame of our search parameters to focus on information published during this time. Besides altering our search time frame, information regarding Aetna and WakeMed Health & Hospitals partnership is readily available in public, and on various sources, including news articles and reports, and insurance and healthcare systems press releases.
Sources
Sources

From Part 01
From Part 02
Quotes
  • "The co-branded product, called Aetna Whole Health–Duke Health & WakeMed, brings together Duke Health and WakeMed physicians, hospitals and outpatient facilities, as well as WakeMed Key Community Care (WKCC)."
  • ""This new agreement deepens our long-standing collaborative relationships with Duke Health and WakeMed, and is great news for our current and future customers in North Carolina," said Jim Bostian, president of Aetna's operations in North Carolina, South Carolina and Tennessee."
From Part 03
Quotes
  • "Aetna is working with health care organizations nationwide to develop products and services that support value-driven, patient-centered care for health care consumers. "
  • "Nationally today, about 6.2 million Aetna members receive care from doctors committed to the value-based approach, with approximately 40 percent of Aetna claims payments going to doctors and providers who practice value-based care."
Quotes
  • "Aetna established a valued-based accountable care organization with Durham, N.C.-based Duke Health and Raleigh, N.C.-based WakeMed Health & Hospitals, the Triangle Business Journal reported."
  • ""
Quotes
  • "“This new agreement deepens our long-standing collaborative relationships with Duke Health and WakeMed, and is great news for our current and future customers in North Carolina,” said Jim Bostian, president of Aetna’s operations in North Carolina, South Carolina and Tennessee. “We’re thrilled to align our mutual resources to deliver better value through quality, cost-effective care and improved population health management.”"